Periodic Limb Movement Disorder

Periodic Limb Movement Disorder (PLMD) is often associated with restless legs syndrome (RLS), though they both remain distinct disorders. Though 80 - 90-percent of those with RLS also have PLMD, a reverse is not true.

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Unlike RLS, PLMD only occurs at night, during the sleep hours. Periodic Limb Movement Disorder is a form of nocturnal myoclonus characterized by movement primarily of legs and sometimes arms.

These movements can range from slow circles of the ankles or toes to wild, flailing movements of the legs and arms.

The movements most often occur from one-half second to 40 seconds in length and time between intervals may last from five to 90 minutes. The Association of Sleep Disorder Centers in 1979 stated that 30 movements per night causing partial awakening or arousal had to occur before PLMD was diagnosed.

PLMD usually occurs in deep stage two non-REM sleep and will cause a person to awake, even temporarily from the symptoms. Because of the sleep disturbances, PLMD often causes insomnia and excessive daytime sleepiness.

PLMD typically worsens with age. Estimates are the 5-percent of the 30 to 35-year-old population has PLMD while 44-percent of those 65-years-old and older have the disorder.

The causes for PLMD are unknown though people with Parkinson's disease or narcolepsy are at particular risk for developing the sleep disorder. Also, those taking antidepressants have a higher rate of PLMD than the general population. Caffeine also tends to increase symptoms.

Periodic Limb Movement Disorder is generally diagnosed by conducting an overnight sleep study. The study is painless and can be conducted in one's home or in a hospital or clinic.

Treatment for PLMD may include dopaminergic medications such as ropinirole, pergolide, pramipexole or carbidopa/levodopa or sedative medications that allow uninterrupted sleep. Parkinson's disease drugs may also be used in some cases, as can anticonvulsant medications and benzodiazepines.